Event and Workshop Registration Form
PERSONAL INFORMATION
* First Name:
* Last Name:
Company Name:
Title:
* Email Address:
* Address:
* City:
* State:
* Zip:
* Daytime Phone:
Evening Phone:
Fax:
Other Phone:
* How may we contact you?
Phone
Postcard
Email
Fax
* All calls placed from our office show as private on caller ID. Due to confidentiality laws, when we contact you (via phone, email, postcard, fax, etc.) regarding your registration, may we identify ourselves as a representative from CARE?
Yes
No
Yes, I would like to receive CARE's FREE newsletter, Stepping Stones.
How did you hear about us?
Attorney
At work
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Flyer
Friend
Library
Newspaper
Not specified
Prior participant
Professional referral
Radio
School
Television
Website
Comments:
Be sure to check the checkbox in the top left of every event and workshop you want to attend.
REGISTER FOR EVENTS
REGISTER FOR WORKSHOPS
More Info
DOT Alcohol & Drug Testing Training for Supervisors
on Thursday, May 30, 2013 at CARE, 31900 Utica RD., Fraser, 48026
Cost:
$25.00
Non-Contracted:
$50.00
Tickets:
1
2
Parenting Partner:
More Info
DOT Training for Safety Sensitive Drivers
on Thursday, May 30, 2013 at CARE, 31900 Utica Rd., Fraser, 48026
Cost:
$25.00
Non-Contracted:
$50.00
Tickets:
1
2
Parenting Partner:
More Info
Parenting for Positive Outcomes- CARE 6-1-13
on Saturday, June 1, 2013 at CARE, 31900 Utica Rd., Fraser 48026
Cost:
$30.00
Tickets:
1
2
Parenting Partner:
+ $15.00
More Info
Parenting for Positive Outcomes- My Care HC 7-8-13
on Monday, July 8, 2013 at My Care Health Center, 6900 E. 10 Mile, Center Line
Cost:
$30.00
Tickets:
1
2
Parenting Partner:
+ $15.00
More Info
Help! My Teen is Driving Me Nuts!!-Erin Presbyterian 7-8
on Monday, July 8, 2013 at Erin Presbyterian Church, 30000 Gratiot, Roseville
Cost:
$30.00
Tickets:
1
2
Parenting Partner:
+ $15.00
More Info
What to Expect Raising Young Children-Shepherd's Gate 7-11
on Thursday, July 11, 2013 at Shepherd's Gate Lutheran Church, 12400 23 Mile, Utica
Cost:
$20.00
Tickets:
1
2
Parenting Partner:
More Info
Parenting for Positive Outcomes- Clinton Mac Lib 7-11-13
on Thursday, July 11, 2013 at Clinton Mac Lib-South Branch, 35891 S. Gratiot, Clinton Twp.
Cost:
$30.00
Tickets:
1
2
Parenting Partner:
+ $15.00
More Info
Help! My Teen is Driving Me Nuts!!-Christ Luth 7-22-13
on Monday, July 22, 2013 at Christ Lutheran Church, 32300 Schoenherr, Warren
Cost:
$30.00
Tickets:
1
2
Parenting Partner:
+ $15.00
More Info
What to Expect Raising Young Children-Bethel Luth 7-23-13
on Tuesday, July 23, 2013 at Bethel Lutheran Church, 26400 Little Mack, SCS
Cost:
$20.00
Tickets:
1
2
Parenting Partner:
More Info
Help! My Teen is Driving Me Nuts!!-American Luth 7-22-13
on Tuesday, July 23, 2013 at American Lutheran Church, 38795 Mulberry, Clinton Twp.
Cost:
$30.00
Tickets:
1
2
Parenting Partner:
+ $15.00
More Info
Help! My Teen is Driving Me Nuts!! CARE 8-10-13
on Saturday, August 10, 2013 at CARE, 31900 Utica Rd., Fraser 48026
Cost:
$30.00
Tickets:
1
2
Parenting Partner:
+ $15.00
